Social Norms Research 2008-09

2008

Objectives: To measure relative effectiveness of tobacco countermarketing advertisements by category and emotive execution style among young adults. Methods: Participants (n=1011) from 2 US 4-year colleges, one southern and one northern were surveyed before and after viewing advertisements in one of 3 categories: social norms, health consequences, or tobacco industry manipulation and with 4 emotive execution styles: drama, testimonial (negative emotive) and humor, sarcasm (positive). Results: Health consequences and negative emotive advertisements were rated significantly most persuasive. Conclusions: This is the first study to support the effectiveness of tobacco countermarketing advertisements emphasizing the negative emotive health consequences of smoking among young adults.

Objectives: This study compared undergraduate students' perceived versus actual prevalence rates of non-medical use of marijuana, prescription opioids and prescription stimulants. Methods: In 2005, a randomly selected sample of 3639 college students self-administered a Web survey regarding their substance use behaviors and attitudes (68% response rate). Results: The majority of undergraduate students overestimated the prevalence of non-medical use of prescription stimulants (70.2%) and prescription opioids (69.9%) and marijuana use (50.5%) among peers on their campus. The mean difference between perceived versus actual past-year use was considerably greater for non-medical use of prescription stimulants (mean difference=12.2, 95% CI=11.7-12.7) and prescription opioids (mean difference=8.8, 95% CI=8.3-9.2) than marijuana (mean difference=2.9, 95% CI=2.2-3.6). Multivariate regression analysis revealed overestimation of non-medical use of prescription drugs was significantly associated with gender and medical use of prescription drugs. Conclusions: The findings provided strong evidence of misperception of non-medical prescription drug use among college students. Future research and prevention efforts should assess the impact of correcting misperceived norms on reducing non-medical prescription drug use.

Binge drinking is a substantial and growing health problem. Community norms about drinking and drunkenness may influence individual drinking problems. Using data from the New York Social Environment Study (n = 4,000) conducted in 2005, the authors examined the relation between aspects of the neighborhood drinking culture and individual alcohol use. They applied methods to address social stratification and social selection, both of which are challenges to interpreting neighborhood research. In adjusted models, permissive neighborhood drinking norms were associated with moderate drinking (odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.05, 1.55) but not binge drinking; however, social network and individual drinking norms accounted for this association. By contrast, permissive neighborhood drunkenness norms were associated with more moderate drinking (OR = 1.20, 95% CI: 1.03, 1.39) and binge drinking (OR = 1.92, 95% CI: 1.44, 2.56); the binge drinking association remained after adjustment for social network and individual drunkenness norms (OR = 1.58, 95% CI: 1.20, 2.08). Drunkenness norms were more strongly associated with binge drinking for women than for men (p(interaction) = 0.006). Propensity distributions and adjustment for drinking history suggested that social stratification and social selection, respectively, were not plausible explanations for the observed results. Analyses that consider social and structural factors that shape harmful drinking may inform efforts targeting the problematic aspects of alcohol consumption.

Objective: Social influences to drink are important predictors of adolescent drinking. This study explored a social influence model of drinking among inner-city adolescents. We examined the role of family drinking and perceived drinking norms in predicting 1-year follow-up perceived social benefits of drinking and the relationship of perceived social benefits of drinking with 2-year follow-up adolescent drinking. Method: Participants in the present study were from the control schools of a randomized trial investigating the etiology and prevention of adolescent alcohol use. During a class period at baseline in seventh grade, participants completed a questionnaire that measured self-reported alcohol use and potential predictors. The panel sample consisted of 1,318 students from baseline (seventh grade), 1 -year follow-up (eighth grade), and 2-year follow-up (ninth grade). Results: Structural equation modeling found that both family drinking and perceived drinking norms affected the perceived benefits of drinking. In turn, the perceived benefits of drinking predicted subsequent drinking, controlling for earlier drinking. Conclusions: These results illuminate the importance of the perceived benefits of drinking, as well as social influences to drink, in adolescent drinking. Therefore, they should be incorporated into alcohol prevention programs.

BACKGROUND: Studies have shown that university/college students tend to have an exaggerated view of the quantities of alcohol being consumed by their peers. Making students aware of this misperception may help change behaviour and reduce problem drinking. METHODS/DESIGN: A Solomon Three Group Design will be used. There is one intervention group and two control groups, controlling separately for measurement and for intervention effects. Recruitment, consent, randomisation and data collection are all on-line. The primary outcomes are AUDIT Score, weekly consumption, perceived social norms, and alcohol related problems; secondary outcomes include alcohol expectancies and other health behaviours. DISCUSSION: This trial will provide information on the effectiveness of an on-line personalized normative feedback intervention for alcohol misuse in university students.

Greek-affiliated college students have been found to drink more heavily and frequently than other students. With female student drinking on the rise over the past decade, sorority women may be at particular risk for heavy consumption patterns. The current study is the first to apply the Theory of Planned Behavior (TPB) to examine drinking patterns among a sorority-only sample. Two-hundred and forty-seven sorority members completed questionnaires measuring TPB variables of attitudes, norms, perceived behavioral control, and intentions, with drinking behaviors measured one month later. Latent structural equation modeling examined the pathways of the TPB model. Intentions to drink mediated the relationship between attitudes and norms on drinking behavior. Subjective norms predicted intentions to drink more than attitudes or perceived behavioral control. Perceived behavioral control did not predict intentions but did predict drinking behaviors. Interpretation and suggestions from these findings are discussed.

The social norms approach to college drinking suggests that students misperceive the drinking behavior and attitudes of their peers. While much is known about these misperceptions, research is sparse regarding the context in which perceived and actual norms are assessed. As social influence is pronounced in college, the principles of Social Impact Theory may contribute to differences between assessments performed individually and those completed when surrounded by members of one's salient reference group. The current study examines 284 members of campus organizations in two contexts (online and group) to determine if individuals endorse different responses to questions of perceived and actual drinking norms across contexts. All participants endorsed higher responses on questions of actual and perceived group behavior and of perceived group attitudes towards drinking during the group assessment. Men and students in Greek organizations may be more influenced by the proximity of their peers when presented with questions regarding perceived alcohol use. These results suggest that context of assessment needs to be considered when collecting self-report data from college students.

The Internet may be an effective medium for delivering smoking prevention to children. Consider This, an Internet-based program, was hypothesized to reduce expectations concerning smoking and smoking prevalence. Group-randomized pretest-posttest controlled trials were conducted in Australia (n = 2,077) and the United States (n = 1,234) in schools containing Grades 6 through 9. Australian children using Consider This reported reduced 30-day smoking prevalence. This reduction was mediated by decreased subjective norms. The amount of program exposure was low in many classes, but program use displayed a dose-response relationship with reduced smoking prevalence. American children only reported lower expectations for smoking in the future. Intervening to prevent smoking is a challenge, and this data suggest small benefits from an Internet-based program that are unlikely to be of practical significance unless increased by improved implementation. Implementation remains the major challenge to delivering interventions via the Internet, both for health educators and researchers.

This study examined alcohol use and related social normative perceptions among a sample of 1,886 Central-Eastern European high school students. The youth represented in the study averaged 16.5 years of age and were from several localities in the countries of Hungary, Slovakia, Czech Republic, and Romania. Data for the study were collected through a school-based alcohol use survey that was completed in June 2005. Our results support the hypothesis that drinking was related to perception of the prevalence of alcohol use by schoolmates and by the number of friends who drink and/or engage in episodic heavy drinking. Specific implications of findings in terms of substance use prevention are discussed. In addition, the need for future research and the limitations of the current research are discussed. This study was largely financially supported through an international grant from the College of Health and Human Performance, Brigham Young University.

Rimal, R. N. (2008). Modeling the relationship between descriptive norms and behaviors: A test and extension of the Theory of Normative Social Behavior (TNSB). Health Communication, 23, 103-16.

Informed by the theory of normative social behavior, this article sought to determine the underlying mediating and moderating factors in the relationship between descriptive norms and behavioral intentions. Furthermore, the theory was extended by asking whether and what role behavioral identity played in normative influences. Simulating the central message of norms-based interventions to reduce college students' alcohol consumption, in this field experiment, descriptive norms were manipulated by informing half of the students (n = 665) that their peers consumed less alcohol than they might believe. Others (n = 672) were not provided any norms information. students' injunctive norms, outcome expectations, group identity, behavioral identity, and behavioral intention surrounding alcohol consumption were then measured. Exposure to the low-norms information resulted in a significant drop in estimates of the prevalence of consumption. Injunctive norms and outcome expectations partially mediated and also moderated the relationship between descriptive norms and behavioral intentions. Group identity and behavioral identity also moderated the relationship between descriptive norms and behavioral intentions, but the effect size was relatively small for group identity. Implications for health campaigns are also discussed.

Vandello, J. A., Cohen, D., & Ransom, S. (2008). US southern and northern differences in perceptions of norms about aggression - Mechanisms for the perpetuation of a culture of honor. Journal Of Cross-Cultural Psychology, 39, 162-177.

This article explores one reason why norms for male honor-related aggression persist in the U.S. South, even though they may no longer be functional. The authors suggest that, in addition to cultural differences in internalized honor-related values, southerners are more likely than northerners to perceive peer endorsement of aggression norms. Study I found that southern males were especially likely to overestimate the aggressiveness of their peers. Study 2 tested the hypothesis that southerners would be more likely to actively encourage aggressive behavior in others, but no support was found. However, Study 3 found that southern men were more likely than northern men to perceive others as encouraging aggression when witnessing interpersonal conflicts. Together, these studies suggest that southern males are more likely than their northern counterparts to assume their peers endorse and enforce norms of aggression that can lead to the perpetuation of norms for honorable violence above and beyond any differences in internalized values.

The present study predicts cigarette and alcohol use in adolescence from the development of children's cognitions in the elementary years. Using latent growth modeling, the authors examined a model using data from 712 participants in the Oregon Youth Substance Use Project, who were in the 2nd through 5th grade at the 1st assessment and followed for 6 annual or semiannual assessments over 7 years. Growth in children's prototypes and subjective norms in the elementary years (Times I through 4) were related to their substance use in adolescence (Time 6) through their willingness and intentions (Time 5) to smoke and drink. Across the sample, for both substances, the intercept and slope of prototypes were either indirectly related to use through willingness or directly related to use. Both the intercept and slope of subjective norms were indirectly related to use of both substances through both willingness and intentions and directly related to cigarette use. Results suggest that elementary children have measurable cognitions regarding substance use that develop during the elementary years and predict use later in adolescence. These findings emphasize the need for prevention programs targeted at changing children's social images of substance users and encouraging more accurate perceptions of peers' use.

This research evaluated the efficacy of a live and interactive group-specific normative feedback intervention designed to correct misperceptions of alcohol-related group norms and subsequently reduce drinking behavior. Campus organizations (N = 20) containing 1,162 college students were randomly assigned to intervention or assessment-only control conditions. Participants in the intervention condition attended an intervention during their organization's regular standing meeting. Data were gathered in vivo using computerized handheld keypads into which participants entered personal responses to a series of alcohol-related questions assessing perceptions of normative group behavior as well as actual individual behavior. These data were then immediately presented in graphical form to illustrate discrepancies between perceived and actual behavioral group norms. Results indicated that compared with the control group, the intervention group reduced drinking behavior and misperceptions of group norms at I-month and 2-month follow-ups. Changes in perceived norms mediated the reductions in drinking. Results demonstrate the effectiveness of a novel, technologically advanced, group-based, brief alcohol intervention that can be implemented with entire groups at relatively low cost.

Background: Binge drinking has been highlighted as a growing problem in the UK, particularly amongst females aged 18-25 years. University of Leeds is situated within a population that has one of the highest reported statistics of binge drinking in the UK. In September 2006, the 'Unit 1421' campaign was launched at University of Leeds with the aim to promoted sensible drinking amongst students. The aim of this study is to explore female perspectives on binge drinking and on 'Unit 1421' campaign in the University of Leeds. Methods: Using a purposive sample, two focus groups were conducted with 12 female students aged 18-23 years within university grounds. Participants were recruited via email and poster advertisements on campus. Results: Four main themes emerged from the data: (i) lay perception of binge drinking; (ii) pressures of matching the drinking patterns of male peers; (iii) student rite of passage; (iv) evaluation of the 'Unit 1421' campaign. Conclusion: The social context of student life impacts greatly upon students' choices to binge drink. The norms, beliefs and morals governing student culture and the use of alcohol to assert identity should be considered when tailoring health promotion efforts to this target audience. Larger qualitative and ultimately quantitative studies are warranted to extrapolate and test the social pressures on drinking in this age group.

Injection drug users who exchange sex for money or drugs may serve as a bridge group for transmitting HIV between injectors and non-injectors. While many individual characteristics have been linked to exchanging sex, little attention has been given to the influence of social network members. The present study assessed the relationship between exchanging sex and perceptions of peers' sex exchange behaviour and attitude toward sex exchange. The sample was composed of 267 women heroin and cocaine injectors in Baltimore, MID, USA. The results indicate that women who believed that their friends exchanged sex were more twice as likely to exchange sex in the past 90 days (95% CI: 1.49-2.70). Also, participants who thought their peers disapproved of sex exchange were 20% less likely to exchange sex (95% CI: 0.67-0.95). These findings suggest the need for peer education interventions that promote norms about safer behaviours.

Two field experiments examined the effectiveness of signs requesting hotel guests' participation in an environmental conservation program. Appeals employing descriptive norms (e.g., "the majority of guests reuse their towels") proved superior to a traditional appeal widely used by hotels that focused solely on environmental protection. Moreover, normative appeals were most effective when describing group behavior that occurred in the setting that most closely matched individuals' immediate situational circumstances (e.g., "the majority of guests in this room reuse their towels"), which we refer to as provincial norms. Theoretical and practical implications for managing proenvironmental efforts are discussed.

The Social Norms Analysis Project (SNAP), conducted with rural high school students in Tasmania, demonstrates the powerful nature of the perceptions of what one's peers think and do, and is based on a model of health promotion that has been used successfully overseas. Baseline data indicate that the SNAP target groups hold inaccurate notions of fellow students' alcohol-related behaviours and attitudes. The Social Norms model is presented as a theoretically informed, evidence-based model for reducing alcohol-related harm in youthful populations by utilising the complex and often positive contributions peer groups make to adolescent health and wellbeing.

Alcohol consumption among college students has become an increasing problem that requires attention from college administrators, staff, and researchers. Despite the physiological differences between men and women, college women are drinking at increasingly risky rates, placing them at increased risk for negative consequences. The current study tested a group motivational enhancement approach to the prevention of heavy drinking among 1st-year college women. Using a randomized design, the authors assigned participants either to a group that received a single-session motivational enhancement intervention to reduce risky drinking that focused partly on women's specific reasons for drinking (n = 126) or to an assessment-only control group (n =94). Results indicated that, relative to the control group participants, intervention participants drank fewer drinks per week, drank fewer drinks at peak consumption events, and had fewer alcohol-related consequences over a 10-week follow-up. Further, the intervention, which targeted women's reasons for drinking, was more effective in reducing consumption for participants with high social and enhancement motivations for drinking.

This research evaluated the efficacy of a live and interactive group-specific normative feedback intervention designed to correct misperceptions of alcohol-related group norms and subsequently reduce drinking behavior. Campus organizations (N = 20) containing 1,162 college students were randomly assigned to intervention or assessment-only control conditions. Participants in the intervention condition attended an intervention during their organization's regular standing meeting. Data were gathered in vivo using computerized handheld keypads into which participants entered personal responses to a series of alcohol-related questions assessing perceptions of normative group behavior as well as actual individual behavior. These data were then immediately presented in graphical form to illustrate discrepancies between perceived and actual behavioral group norms. Results indicated that compared with the control group, the intervention group reduced drinking behavior and misperceptions of group norms at 1-month and 2-month follow-ups. Changes in perceived norms mediated the reductions in drinking. Results demonstrate the effectiveness of a novel, technologically advanced, group-based, brief alcohol intervention that can be implemented with entire groups at relatively low cost.

This research was designed to evaluate a personalized normative feedback birthday card intervention aimed at reducing normative perceptions, alcohol consumption, and negative consequences associated with 21st birthday celebrations among college students (N=281; 59.15% women). Students were randomly assigned to receive or not receive a birthday card about 1 week prior to their 21st birthday. Approximately 1 week following their birthday, students were asked to complete a brief survey concerning their birthday celebration activities. Findings indicated that the birthday card intervention was not successful at reducing drinking or consequences; however, the card did reduce normative misperceptions. Additional findings indicated that many students experienced negative consequences, such as passing out or driving after consuming alcohol. Combined, these findings suggest that prevention is needed for drinking associated with turning 21. However, prevention efforts should consist of more than a birthday card.

This experiment examined whether the efficacy of an appearance-based sun protection intervention could be enhanced by the addition of social norms information. Southern California college students (N =125, predominantly female) were randomly assigned to either an appearance-based sun protection intervention that consisted of a photograph depicting underlying sun damage to their skin (UV photo) and information about photoaging or to a control condition. Those assigned to the intervention were further randomized to receive information about what one should do to prevent photoaging (injunctive norms information), information about the number of their peers who currently use regular sun protection (descriptive norms information), both injunctive and descriptive norms information, or neither type of norms information. The results demonstrated that those who received the UV photo/photoaging information intervention expressed greater sun protection intentions and subsequently reported greater sun protection behaviors than did controls. Further, the addition of both injunctive and descriptive norms information increased self-reported sun protection behaviors during the subsequent month.

The present research investigated the persuasive impact and detectability of normative social influence. The first study surveyed 810 Californians about energy conservation and found that descriptive normative beliefs were more predictive of behavior than were other relevant beliefs, even though respondents rated such norms as least important in their conservation decisions. Study 2, a field experiment, showed that normative social influence produced the greatest change in behavior compared to information highlighting other reasons to conserve, even though respondents rated the normative information as least motivating. Results show that normative messages can be a powerful lever of persuasion but that their influence is underdetected.

Turner, J., Perkins, H. W., & Bauerle, J. (2008). Declining negative consequences related to alcohol misuse among students exposed to a social norms marketing intervention on a college campus. Journal of American College Health, 57, 85-93.

Objective: The authors examined whether alcohol-related negative consequences decreased among students exposed to an intervention. Participants: Beginning in 1999, approximately 2,500 randomly selected undergraduates from a 4-year US university annually participated in a Web-based survey over 6 years. Methods: The educational intervention used social norms initiatives. Main outcome measures included recall of intervention, estimated blood alcohol content (eBAC) when drinking, and 10 negative consequences from alcohol within the past year. Results: First-year students recalling exposure had lower odds of negative consequences (odds ratio [OR] = 0.78, 95% confidence interval [CI] = 0.64-0.95) and of having an eBAC higher than .08 (OR = 0.76, 95% CI = 0.62-0.92). Over the 6 study years, the odds among all participants of experiencing (a) none of 10 alcohol consequences nearly doubled (OR = 2.13, 95% CI = 1.82-2.49) and (b) multiple consequences decreased by more than half (OR = 0.43, 95% CI = 0.36-0.50). Conclusions: These findings have important implications for US colleges and universities engaged in the reduction of harm associated with alcohol misuse.

2009

Background: Certain types of human papillomavirus (HPV) can cause cervical and other cancers. A vaccine that protects against HPV types responsible for 70% of cervical cancers is available to females ages 9-26. Objective: To examine correlates of stage of vaccine adoption among women ages 18-22. Methods: In 2007, female students (n = 4774) at a New England University in the U.S. were invited to complete an on-line survey that assessed knowledge of HPV, perceived susceptibility, severity, vaccine benefits/barriers, social and subjective norms, and stage of vaccine adoption. Results: 1897 women (40%) responded; complete data were available for 1401. About half (53%) were planning to be vaccinated, 12% had received the vaccine, 15% were undecided, and 7% had decided against vaccination. HPV knowledge was low (mean 58%). In multivariate analyses, social norms was the strongest correlate of stage; each standard deviation increase in social norms score was associated with more than four times the odds of intending to be vaccinated within the next 30 days, compared with those who had decided against vaccination (OR = 4.15; 95% CI 2.17-6.36). Conclusions: Acceptance of the vaccine was high, although misconceptions about viral transmission, availability of treatment, and the role of Pap tests were common. Perceived norms were strongly associated with intentions. Interventions on college campuses should stress vaccination as a normative behavior, provide information about viral transmission, and stress the role of continued Pap screening.

Objective: The authors assessed short-term effectiveness of a Web-based alcohol education program on entering freshmen. Participants: 3,216 incoming first-year students were randomized to a control or intervention group. Methods: Controls completed a survey and knowledge test the summer before college; 4 to 6 weeks after arrival on campus, they completed a follow-up survey of behaviors and harms followed by an invitation to complete the online course. Intervention students completed the precourse survey and test, the online course, and final exam prior to coming to campus. This was followed by a survey 4 to 6 weeks after arrival on campus. Results: Although the intervention group showed significantly higher alcohol-related postcourse knowledge compared to the control group, protective behavior, risk-related behavior, high-risk drinking, and alcohol-related harm did not favor the intervention group, with the sole exception of playing drinking games. Conclusions: Alcohol knowledge alone was insufficient to mitigate alcohol-related high-risk behaviors in this student population.

This study evaluated the efficacy of two Web-based interventions aimed at reducing heavy drinking in mandated college students. Mandated students were randomly assigned to one of two conditions: Web-based personalized normative feedback (WPNF) or Web-based education (WE). As predicted, results indicated that mandated students in the WPNF condition reported significantly greater reductions in weekly drinking quantity, peak alcohol consumption, and frequency of drinking to intoxication than students in the WE condition at a 30-day follow-up. Although not statistically significant, there was a similar trend for changes in alcohol-related problems. Mandated students in the WPNF group also reported significantly greater reductions in estimates of peer drinking from baseline to the follow-up assessment than students in the WE group. In addition, changes in estimates of peer drinking mediated the effect of the intervention on changes in drinking. Findings provide support for providing Web-based personalized normative feedback as an intervention program for mandated college students.